发育障碍的概况及其与胎龄的关系。

IF 4.3 3区 医学 Q1 PEDIATRICS
Katherine Jane Pettinger, Sarah Louise Blower, Elaine M Boyle, Catherine Elizabeth Hewitt, Lorna K Fraser
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引用次数: 0

摘要

目的:本研究旨在探讨发育障碍的共同发生及其与足月前出生的关系。设计:对具有关联健康数据的队列数据进行潜在分类分析。背景:英国布拉德福德。患者:13 172名儿童纳入分析。结果测量:医疗记录中的发育障碍。方法:在每个孩子12岁生日时对数据进行审查。潜在分类分析确定了发育障碍的模式。多项逻辑回归探讨与胎龄的关系,同时调整临床和社会因素。结果:大多数(12,536)发育障碍的风险较低;这一群体被命名为“典型发展”。剩下的孩子被分为三组:“教育困难”(347名);“社交、情感、行为和沟通困难”(189名儿童)和“早期发育障碍,身体和智力残疾”(100名儿童)。与“典型发育”相比,极早产与“早期发育障碍,身体和智力残疾”组的可能性增加有关,调整相对风险比(aRRR): 9.22 (95% CI 4.58至18.55)。足月前出生的孩子进入“教育困难”群体的可能性增加;结论:确定了发育障碍的四种不同特征;胎龄与其中两项有关。了解儿童最易患哪些疾病以及这些疾病如何同时发生,有助于向家庭提供准确信息并有助于及时诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Profiles of developmental disorder and associations with gestational age.

Objective: This study aimed to examine profiles of co-occurrence of developmental disorders and their association with birth before full term.

Design: Latent class analysis of cohort data with linked health data.

Setting: Bradford, England.

Patients: 13 172 children were included in the analysis.

Outcome measures: Developmental disorder in medical records.

Methods: Data were censored at each child's 12th birthday. The latent class analysis identified patterns of developmental disorders. Multinomial logistic regression explored the association with gestational age while adjusting for clinical and socio-factors.

Results: The majority (12,536) had a low risk of developmental disorders; this group was named 'typical development'. The remaining children were classified into three groups: 'educational difficulties' (347 children); 'social, emotional, behavioural and communication difficulties' (189 children) and 'early developmental impairment, with physical and intellectual disabilities' (100 children).Compared with 'typical development', very preterm birth was associated with an increased likelihood of being in the 'early developmental impairment, with physical and intellectual disabilities' group, adjusted relative risk ratio (aRRR): 9.22 (95% CI 4.58 to 18.55). Birth before full term was associated with increased likelihood of being in the 'educational difficulties' group; risk was highest <34 weeks (aRRR: 2.64 (95% CI 1.44 to 4.83)) but persisted up to 37-38 weeks: aRRR: 1.41 (95% CI 1.10 to 1.81). There was no association between gestational age and the 'social, emotional, behavioural and communication difficulties'' group.

Conclusion: Four distinct profiles of developmental disorders were identified; gestational age was associated with two of these. Understanding which disorders children are most at risk of and how these co-occur can help provide accurate information to families and contribute to prompt diagnosis.

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来源期刊
CiteScore
5.80
自引率
3.80%
发文量
291
审稿时长
3-6 weeks
期刊介绍: Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.
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